Justin Douglas McDonald, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

271 Issued in ND

Practice address

White Earth Mental Health
26246 Crane Rd
White Earth, MN 56591

Phone

(218) 983-4703

NPI assigned

Sep 3, 2008

Last updated

May 17, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Circle of Life Recovery Center

  • Addiction (Substance Use Disorder) Counselor
  • New Town, ND
  • NPI 1477786051
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526515200000",
    "number": "1467600452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2394 34TH AVE NE",
            "city": "ARDOCH",
            "state": "ND",
            "postal_code": "582619302",
            "telephone_number": "701-777-4495",
            "fax_number": "701-777-6498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WHITE EARTH MENTAL HEALTH",
            "address_2": "26246 CRANE RD",
            "city": "WHITE EARTH",
            "state": "MN",
            "postal_code": "56591",
            "telephone_number": "218-983-4703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "JUSTIN",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-03",
        "last_updated": "2018-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ND",
            "license": "271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Willy Ann Heisler, S.W.
• Katie Lynn Hoban, RDN, LD
• Jacqueline Jacobson, LPCC
• Sarah Jane Jasken, M.S.W; LICSW
• Diane McArthur, RD,LD
• Amy Nathe, LPCC
• Kristin Petersen
• Shania Rentschler, LPCC
• Nancy Fredericka Samura
• James M. Schmitt, LSW

• Clinical Psychologist in White Earth, MN
• Providers in White Earth, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.